Individual provider Active NPI

Michael P Crouchley, D.C.

  • Chiropractor
  • Newington, CT
National Provider Identifier
1316983067
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
748 Issued in CT
Practice address
21 Garfield St
Newington, CT 06111-2834
Phone
(860) 665-0001
Fax
(860) 665-0003
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 748 CT Primary

Addresses

Primary practice location

21 Garfield St
Newington, CT 06111-2834

Mailing address

21 Garfield St
Newington, CT 06111-2834
Phone (860) 665-0001

Other identifiers 1

IdentifierTypeStateIssuer
050000748CT01OtherCTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090925000146 CT Practitioner - Chiropractic 9537215041 Practice locations: Newington, CT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Garfield St
Newington, CT 06111-2834
Phone (860) 665-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000748CTMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1316983067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GARFIELD ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112834",
            "telephone_number": "860-665-0001",
            "fax_number": "860-665-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GARFIELD ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112834",
            "telephone_number": "860-665-0001",
            "fax_number": "860-665-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCHLEY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "050000748CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.